Excessive sodium has been recognized for many years as a danger to health due to its link to high blood pressure. While Americans typically consume around 3,400 mg of sodium per day, our bodies actually need less than 500 mg of sodium per day to function properly. Of course, a little extra salt in one’s diet is not necessarily harmful. The 2015 USDA Dietary Guidelines recommends Americans limit daily consumption of sodium to 2,300 mg. The American Heart Association (AHA) recommends consuming even less – 1,500 mg – of sodium per day (this recommendation does not apply to professional or competitive athletes or workers who may lose large amounts of salt via perspiration).
Unfortunately, the amount of salt in the foods we eat regularly is astonishing. The “Salty Six” is a list from the AHA of the six most common sources of salt in a typical diet. These items include: 1) Bread and Rolls, 2) Cold Cuts and Cured Meats, 3) Pizza, 4) Poultry, 5) Soup, and 6) Sandwiches. A four ounce slice of cheese pizza can contain as much as 760 mg of sodium, and one fast food cheeseburger can contain up to 1,690 mg of sodium. Even worse, one large steak sub sandwich can contain as much as 4,300 mg of sodium, nearly double the daily recommended intake of sodium based on the USDA Dietary Guidelines.
A little goes a long way for salt and steps can also be taken at home to reduce consumption. Just one teaspoon of table salt equals 2,300 mg of sodium. Therefore, cutting the table salt in home cooked foods, or excluding it altogether, can have a considerable impact. The AHA provides a downloadable “Sodium Tracker” that consumers can use to track their sodium consumption.
Consumers can control the amount of salt on home cooked items, but what can consumers do about the foods they purchase in restaurants or grocery stores? Legal regulation of sodium levels could reduce sodium intake from store bought foods. On June 1, the FDA issued proposed voluntary guidelines for food manufacturers to reduce the level of sodium in processed foods. The voluntary guidelines identify short-term (two years) and long-term (10 years) targets for mean sodium concentrations for various food categories (e.g., dairy, fruits and vegetables, soup, etc.). FDA’s goal is to reduce daily sodium consumption in the U.S. to 2,300 mg/day, which is reasonable if the food industry follows the sodium concentrations provided.
Recent efforts to regulate sodium levels have been challenging, however. For example, on September 9, 2015, the NYC Board of Health unanimously approved a requirement that chain restaurants (with more than 15 locations) post warning labels next to items containing high levels of sodium. This requirement was challenged in court by the National Restaurant Association in late 2015, based on the argument that it unfairly burdened restaurant owners. An interim stay was placed in February 2016 on the warning label requirement. On May 26, NY’s Appellate Division vacated the interim stay, allowing the requirement to go into effect. Enforcement of the warning label requirement began on June 6.
These and other national, state, and local initiatives to assist the U.S. population reduce its sodium intake is a move in the right direction for public health.
This post was developed by Leila Barraza, J.D., M.P.H., Consultant, Network for Public Health Law – Western Region at the Sandra Day O’Connor College of Law, Arizona State University, and Assistant Professor, Mel and Enid Zuckerman College of Public Health, University of Arizona.
The Network for Public Health Law provides information and technical assistance on issues related to public health. The legal information and assistance provided in this post does not constitute legal advice or legal representation. For legal advice, readers should consult a lawyer in their state.
Support for the Network is provided by the Robert Wood Johnson Foundation (RWJF). The views expressed in this post do not necessarily represent the views of, and should not be attributed to, RWJF.